Anthem Blue Cross holds our community hostage

An artist renditioning of the new emergency department expansion is set up for those gathered for the ceremony to look ...more

An artist renditioning of the new emergency department expansion is set up for those gathered for the ceremony to look see during the emergency department expansion groundbreaking ceremony at Augusta Health on Wednesday, April 26, 2017.

When 2017 expires, so apparently will the in-network contract between Augusta Health and Anthem Blue Cross/Blue Shield.

Come Monday, going to Augusta Health will no longer be an affordable option for many people in our community, including many state workers and retirees. They’ll still get reasonable coverage for care that’s truly an emergency, but beyond that patients will either have to pay more or go elsewhere if cost is a concern.

We realize there’s give and take in any negotiation, but we also have no reason to disbelieve Augusta Health’s contention that it’s being offered far less for its services than are Sentara and University of Virginia hospitals. It’s just the latest challenge faced by the local, non-profit hospital as it resists the consolidation that’s rolled over so many rural hospitals in Virginia.

It certainly appears that the for-profit, multi-state insurance behemoth would rather cut sweetheart deals with one-size-fits-all chain hospitals. Nothing would be easier, and cheaper, for Anthem than dealing with just two or three networks in Virginia, so it’s not tough to read these low-ball reimbursements as an attempt to forward that goal. Starve the little guys until they’re weak enough that they have to sell out. This is less of a negotiation than a siege.

And it could be disastrous for our community.

We’ve seen the social media critiques of Augusta Health, of course. Some people are confused about what it means to be non-profit. Others express dismay about imperfect outcomes or unpleasant experiences. Put those things aside.

What matters is that Augusta Health is a community-based non-profit. It’s working for us. It is the successor to the two community hospitals that served Staunton and Waynesboro until the early 1990s. And its goal is community service, with its excess income reinvested in the operation. The current emergency department expansion is a prime example.

Augusta Health is bucking a consolidation trend that is being furthered by Anthem, itself a consolidated for-profit corporation based in Indiana.

By fighting for its independence, Augusta Health is the David to Anthem’s Goliath. And we’re rooting for David.

In a perfect world, we’ve said before, we’d be like every other major industrialized country, recognizing health care as a basic human right. Because it is. From that concept flows universal coverage and a much-reduced role, if any, for parasitic for-profit insurers.

Until that day comes, we’re proud that our community hospital hasn't caved to Anthem, because doing so now and heading down that road would be tantamount to signing its own death warrant.

Everyone who has Anthem coverage should be raising cane with the insurer. Every employer who covers their employees with any Blue Cross plan should be doing likewise. We don’t know how long this will drag out, but subscriber pressure should be brought to bear to break the impasse.

Only if those people who pay Anthem for services stand up, and threaten Anthem’s bottom line will the insurer find it in their own best interest to pay Augusta Health the reimbursement rates it deserves.

When profit is your only motive, that’s the only language you understand.